During the last 4 years, the PESC has invested -$650,000 (total costs) in 7 pilot/exploratory studies that have resulted, to date, in 27 publications and ~$17.2 million (total costs) in extramural funding received or expected by July 2012, with an additional ~$7.9 million (5 grants) currently under review. The primary goal of the PESC is to facilitate the development of innovative and rigorous research studies that will enhance our understanding ofthe pathogenesis, etiology, diagnosis, prevention, and management of multifactorial geriatric health conditions (the stated focus ofthe Yale OAIC), leading ultimately to the development of efficacious and cost-effective interventions to increase or maintain the independence of older Americans. The specific aims are to: (1) solicit and select the most meritorious research proposals for PESC funding; (2) provide investigators of Pilot / Exploratory Studies (PESs) with access to resources from the other OAIC Cores; (3) identify potential opportunities for co-sponsorship of PESs; (4) identify potential opportunities for collaboration among PESC investigators; (5) monitor the progress of PESs; (6) provide assistance so that the PESs can be successfully developed into independently funded grant applications; and (7) ensure the safety and protection of human subjects and vertebrate animals enrolled in PESs. Priority for PESC funding will be given to junior investigators as well as to accomplished mid-career and senior investigators who wish to redirect or expand their research to the study of multifactorial geriatric health conditions. In addition to traditional one- or two-year PESs, we propose a new Expedited Pilot Program (EXPI), which will fund small grants capped at a maximum of $5000 that will be awarded within 4 weeks of application. These grants will be limited to junior investigators, up to and including the level of Assistant Professor, and are intended for research activities in which a rapid infusion of a relatively small amount of funds will facilitate a successful extramural grant application. These two PESC grant mechanisms will provide crucial support and access to the research infrastructure provided by the OAIC Operations and Biostatistics Cores, facilitating future external grant support that will advance our understanding of multifactorial geriatric health conditions. In partnership with the OAIC Executive Committee, the key tasks ofthe PESC will be achieved by two highly accomplished physician scientists with complementary areas of expertise: Dr. Albert Shaw (Core Leader), a new NIA K24 recipient, and Dr. Mary Tinetti (Core Co-Leader), former Director of the Yale OAIC, who defined the field of research related to multifactorial geriatric health conditions.